HomeMy WebLinkAboutPermit Plumbing 2000-5-1
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I Job# 00-00631-01
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Page 1 of 2
TRANS#:01-0001423
DATE:MAY 01 2000
AMT RECD:2 $ 16.50
CHANGE:
CASHIER:059
SPAINQFIBLD
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CITY OF SPRINGFIELD, OREGON
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-00631-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 650 Main St Spr
Assessors Map#: 17033531
Lot: Block: Addition:
Tax Lot #: 09000
Subdivision:
Owner:
Glen Remington
650 Main St
Phone Number: 541-747-1897
City/State/Zip: Springfield, OR 97477
Alteration Value: $0
Address:
Scope Of Work: Plumbing
Contractor Type
Plumbing Contr
Contractor
Barnes High Tech Plumbing Inc
2787 Olympic St Ste 27, Springfield, OR
97477
Registration # Expiration Date
83311 2/17/2002
Phone
541-726-9854
I I
Office Use
Quad Area: Land Use: # Of Buildings:
# Of Units: Zoning Code: Occupancy Group:
Constr. Type: Bedrooms: Heat Source:
Water Heater:' -" "'-' ,Range: Sq. Footage:
'U"nlll.~. , ..........:\.v
lorifir.AI"~~~::' aUOPted b'''h~ ");-" <:0. J" .
To reque~ljl,Q~.~p~~tiOn!c..<!1I !?~,€~ ~ourrr~G_q(q\l)g, at 726-3769. All inspections requested before 7:00
a,m, will b~made:t1ielsam~working oay~inspectioris requested after 7:00 a.m, will be made the following
working -d'ay':"J' rOll may Obt~/~ IOroUQh OAR95~'o'0
"<:I mo rile COPle< Of th - 0
nl'_~.... CentAr ,,,,__.... t:JrLR-'''-'. .
-~, 'ur roe 0 . '-'~, "'e re1epi:)Q eqUlred Inspections
"'~"I". 10 _r~~,?~,;~~lity NOti~"~t':..(3 Plumbing I
Backflow Device -After dev'i'ce'is" instailed but before backfilling trench,
HO:-ln 'OOI1:J3d).V'
construc!i.~ls/l'es~NoaNV'eV' SII:JO a 08 ( ),NV'
occupanSYd?fouWiI:J3d S/H11:J3aN a3~N3WVVOJ
# Of BUildingI!1"3H.L.-:I/31:J/dX3nv: n0341!OfIS1P,rJes:
# Of Bedrooms: HS1lVOu]rent Units:
-VIl1J..
Handicap Access? 0 ::,OJrll5't8ode: Does not apply
rAr~a (Sq, Feet) I
I Mam: Accessory: Total:
Height (feet):
Proposed Units:
Fee
Paid On Receipt#
Plumbing
05/01/2000 1423
Value/Quantity
Fee Amount
Minimum Plumbing Permit Fee
$5.00
....
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Job# 00.00631.01
Paid On Receipt#
Plumbing
05/01/2000 1423
05/01/2000 1423
05/01/2000 1423
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Page 2 of 2
Value/Quantity Fee Amount
Fee
State Surcharge For Plumbing Permit
Backflow Prevention Device
Plumbing Administrative Fee
Total Plumbing
Grand Total
By signature, I state and agree that I have carefully examined the completed application and do
hereby certify that all information herein is true and correct, and I further certify that any and all work
performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of
the State of Oregon, I further state that only contractors and employees who are in compliance with
ORS 701,055 will be used on this project. I further agree to ensure that all required inspections are
requested at the proper time and that the project address is readable from the street.
1
$1.05
$10,00
$.45
$16,50
$16.50
Signature
Date